What is the treatment for poison ivy?

Treatment for Poison Ivy

As soon as exposure to poison ivy is recognized, the affected area should be washed immediately with soap and water or a commercial decontamination product to remove the urushiol oil. 1, 2

Immediate Management

1. Decontamination:

   • Wash exposed area with soap and water or commercial decontamination product
   • Effectiveness decreases rapidly with time: 100% effective immediately, 50% at 10 minutes, 25% at 15 minutes, 10% at 30 minutes 1
   • Also wash clothing, tools, and pets that may have contacted the plant

2. Symptomatic Relief Measures:

   • Cool compresses applied several times daily 1, 2
   • Oatmeal baths for widespread involvement 1, 2
   • Calamine lotion can help dry weeping lesions

Medication Options

Topical Treatments:

• High-potency topical corticosteroids (e.g., clobetasol propionate 0.05%) applied twice daily for moderate cases 2
• Avoid low-potency OTC hydrocortisone (0.2-2.5%) as these have limited efficacy for poison ivy dermatitis 1, 2
• For facial/eyelid involvement: Tacrolimus 0.1% ointment is preferred over corticosteroids to avoid skin atrophy 2

Oral Medications:

• Antihistamines: Limited evidence for effectiveness against poison ivy itch, but may help with sleep disturbance 1, 2

Treatment Based on Severity

Mild Cases:

• Cool compresses
• Oatmeal baths
• High-potency topical corticosteroids

Moderate Cases:

• All treatments for mild cases
• Consider short course of systemic corticosteroids if widespread

Severe Cases (extensive blistering, facial/genital involvement, or systemic symptoms):

• Seek medical attention
• May require systemic corticosteroids
• Monitor for secondary infection

Important Considerations

• Avoid common pitfalls:

  • Don't rely solely on over-the-counter hydrocortisone as it shows limited efficacy 1, 2
  • Don't scratch lesions as this can lead to secondary infection
  • Don't use topical antihistamines, which can cause contact sensitization
  • Don't use topical corticosteroids on eyelids due to risk of skin atrophy 2

• When to seek medical attention:

  • Severe or widespread rash
  • Facial, genital, or widespread involvement
  • Signs of infection (increased pain, swelling, warmth, pus)
  • History of severe reactions to poison ivy
  • Symptoms not improving after 7-10 days of self-treatment

The rash typically resolves within 1-3 weeks without treatment 3, 4, but appropriate interventions can significantly reduce discomfort and potentially shorten the duration of symptoms.